scholarly journals Side-to-end vs. Colonic Pouch vs. End-to-end Anastomosis in Low Anterior Resection

2008 ◽  
Vol 20 (2) ◽  
pp. 61-68
Author(s):  
Akira TSUNODA ◽  
Goichi KAMIYAMA ◽  
Naoto SUZUKI ◽  
Makoto WATANABE ◽  
Kazuhiro NARITA ◽  
...  
Keyword(s):  
Anterior Resection ◽  
Low Anterior Resection ◽  
Colonic Pouch ◽  
End To End

scholarly journals MECHANICAL SUTURE IN RECTAL CANCER

2017 ◽  
Vol 90 (3) ◽  
pp. 305-312
Author(s):  
Cornel Dragos Cheregi ◽  
Ioan Simon ◽  
Ovidiu Fabian ◽  
Adrian Maghiar
Keyword(s):  
Anal Sphincter ◽  
Anterior Resection ◽  
Low Anterior Resection ◽  
Intestinal Function ◽  
Double Row ◽  
Intestinal Continuity ◽  
Manual Anastomosis ◽  
Mechanical Suture ◽  
End To End ◽  
Mechanical Anastomosis

Background and aims. Colorectal cancer is one of the most frequent digestive malignancies, being the third cause of death by cancer, despite early diagnosis and therapeutic progress made over the past years. Standard treatment in these patients is to preserve the anal sphincter with restoration of intestinal function by mechanical colorectal anastomosis or coloanal anastomosis, and to maintain genitourinary function by preservation of hypogastric nerves.Methods. In order to emphasize the importance of this surgical technique in the Fourth Surgical Clinic of the CF Clinical Hospital Cluj-Napoca, we conducted a prospective observational interventional study over a 3-year period (2013-2016) in 165 patients hospitalized for rectal and rectosigmoid adenocarcinoma in various disease stages, who underwent Dixon surgery using the two techniques of manual and mechanical end-to-end anastomosis. For mechanical anastomosis, we used Covidien and Panther circular staplers. The patients were assigned to two groups, group A in which Dixon surgery with manual end-to-end anastomosis was performed (116 patients), and group B in which Dixon surgery with mechanical end-to-end anastomosis was carried out (49 patients).Results. Mechanical anastomosis allowed to restore intestinal continuity following low anterior resection in 21 patients with lower rectal adenocarcinoma compared to 2 patients in whom intestinal continuity was restored by manual anastomosis, with a statistically significant difference (p<0.000001). The double-row mechanical suture technique is associated with a reduced duration of surgery (121.67 minutes for Dixon surgery with mechanical anastomosis, compared to 165.931 minutes for Dixon surgery with manual anastomosis, p<0.0001).Conclusion. The use of circular transanal staplers facilitates end-to-end anastomosis by double-row mechanical suture, allowing to perform low anterior resection in situations when the restoration of intestinal continuity by manual anastomosis is technically not possible, with the aim to preserve the anal sphincter, to restore intestinal function and maintain genitourinary function through preservation of hypogastric nerves.

scholarly journals Similar Outcome After Colonic Pouch and Side-to-End Anastomosis in Low Anterior Resection for Rectal Cancer

2003 ◽  
Vol 238 (2) ◽  
pp. 214-220 ◽  
Author(s):  
Mikael Machado ◽  
Jonas Nygren ◽  
Sven Goldman ◽  
Olle Ljungqvist
Keyword(s):  
Rectal Cancer ◽  
Anterior Resection ◽  
Low Anterior Resection ◽  
Colonic Pouch

Defunctioning Stoma in Low Anterior Resection With Colonic Pouch for Rectal Cancer

2002 ◽  
Vol 45 (7) ◽  
pp. 940-945 ◽  
Author(s):  
Mikael Machado ◽  
Olof Hallböök ◽  
Sven Goldman ◽  
Per-Olof Nyström ◽  
Johannes Järhult ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Anterior Resection ◽  
Low Anterior Resection ◽  
Colonic Pouch ◽  
Defunctioning Stoma

Colonic pouch vs. side-to-end anastomosis in low anterior resection

1999 ◽  
Vol 42 (7) ◽  
pp. 896-902 ◽  
Author(s):  
Franz T. Huber ◽  
Barbara Herter ◽  
Jörg Rüdiger Siewert
Keyword(s):  
Anterior Resection ◽  
Low Anterior Resection ◽  
Colonic Pouch

Different Role of the Colonic Pouch after Low Anterior Resection or Coloanal Anastomosis

2002 ◽  
pp. 213-223
Author(s):  
Francesco Tonelli ◽  
Alessandro Garcea ◽  
Iacopo Monaci ◽  
Giacomo Batignani
Keyword(s):  
Anterior Resection ◽  
Low Anterior Resection ◽  
Coloanal Anastomosis ◽  
Colonic Pouch

scholarly journals Rectal Reconstruction after Total Mesorectumectomy: Functional Outcomes and Quality of Life

2021 ◽  
Vol 11 (3) ◽  
pp. 195-202
Author(s):  
A. O. Rasulov ◽  
A. B. Baychorov ◽  
A. M. Merzlyakova ◽  
A. I. Ovchinnikova ◽  
A. V. Semyanikhina
Keyword(s):  
Quality Of Life ◽  
Anterior Resection ◽  
Functional Outcomes ◽  
Low Anterior Resection ◽  
Low Anterior Resection Syndrome ◽  
Anterior Resection Syndrome ◽  
Post Surgery ◽  
J Pouch ◽  
End To End

Background. The study aims to compare the functional outcomes and quality of life in patients having variant rectal reconstruction procedures after low anterior resection for cancer.Materials and methods. A prospective randomised controlled trial enrolled 90 patients who underwent total mesorectumectomy with formation of J-pouch (J-P), side-to-end (STE) or end-to-end (ETE) anastomoses.Results and discussion. We analysed 22 J-P, 30 STE and 38 ETE patients. For technical reasons, 26.6 % J-Ps were remodelled to other anastomoses. The neorectal sensory threshold, first and permanent defecation urges and maximal tolerated volume were higher in J-P at months 3–6–12 postoperatively.Severe low anterior resection syndrome events at post-surgery month 6 were significantly more frequent in the ETE vs. J-P and STE cohorts (21, 0 and 3.3 %, respectively, p < 0.05). Stool frequency was significantly lower in J-P vs. STE and ETE at months 3–6–12. Wexner score was 3, 5, 6 at month 6 (p < 0.05) and 0, 1, 1 at month 12 for J-P, STE and ETE, respectively (p > 0.05). Evacuatory dysfunction was present at month 6 in 59.1 J-P, 33.3 STE and 21.1 % ETE.Quality of life (FIQL) in J-P and STE was significantly higher vs. ETE anastomoses in the Lifestyle (3.21, 3.22 and 3.03, respectively, p < 0.05) and Coping (3.29, 3.21 and 2.95, respectively, p < 0.05) scales to month 12 postoperatively.Conclusion. The J-pouch formation after low anterior resection ameliorates anal continence at months 3–6 post-surgery, reduces low anterior resection syndrome and improves quality of life (FIQL). The ease of implementation and irrelevance of evacuatory dysfunction in side-to-end anastomosis make it a superior choice over end-to-end surgery.

scholarly journals Straight and colonic J-pouch reconstruction after low anterior resection

2006 ◽  
Vol 53 (2) ◽  
pp. 109-112 ◽  
Author(s):  
B. Teleky ◽  
Barbara Jech ◽  
Judith Karner-Hanusch ◽  
Irene Kuehrer ◽  
P. Götzinger ◽  
...  
Keyword(s):  
Anterior Resection ◽  
Low Anterior Resection ◽  
Rectal Surgery ◽  
Pelvic Sepsis ◽  
Colonic Pouch ◽  
Functional Evaluation ◽  
Stricture Rate ◽  
Significant Difference ◽  
J Pouch ◽  
Descending Colon

Purpose: A complication after restorative rectal surgery with a straight anastomosis is low-anterior resection syndrome with a postoperatively deteriorated anorectal function. The colonic J-reservoir is sometimes used with the purpose of reducing these symptoms. An alternative method is to use a simple side-to-end anastomosis or a coloplasty. Material and Methods: Three-hundred fifty seven patients with rectal cancer undergoing total mesorectal excision (TME). Three-hundred (84.0%) received a low anterior resection with primary anastomosis and colo-rectal n=194 (64.6%) or colo-anal anastomosis n=106 (35.3%). A colonic pouch using the descending colon was created in 24 patients and in 75 patients respectively. Surgical results and complications were recorded. Patients were followed with a functional evaluation at 6 and 12 months postoperatively. Results: Patient characteristics in both groups were very similar regarding gender, age, tumor level, and Dukes? stages. A large proportion of the patients received short-term preoperative radiotherapy (72%). There was no significant difference in surgical outcome between the 2 techniques with respect to anastomotic height, perioperative blood loss, , postoperative complications, reoperations, hospital stay or pelvic sepsis rates except the anastomotic stricture rate in the colonic J-Pouch group after coloanal anastomosis (p<0.02). Conclusions: These data show that either a colonic Jpouch or a straight anastomosis performed on the descending colon in low-anterior resection with TME are methods that can be used with similar expected surgical and functional results.

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